In 1922 I1 published the results of over five years' work, the object of which had been to impart the requisites of definite broad scleral fixation and definite gradation to the side (tenotomy) where these safeguards had not, to any great extent, been previously applied. In this paper were reported the first 50 cases in which single recession was performed under these accurate safeguards and the somewhat revolutionary knowledge obtained therefrom.
The single study demonstrated among other things the following facts :
The highly energized muscles (i. e., the convergent muscles) are more sensitive to surgical intervention than the other muscles, thus necessitating conservation in gradation. This fact is, on the other hand, offset, because a moderate amount of recession gives a much higher contribution to correction by these highly innervated muscles than the same amount of recession would on the other side, i. e., the passive, advancement side.